The present invention relates to orthopedic braces for glenohumeral joint support.
The glenohumeral joint is invariably unstable due to the convex articulation of the humeral head with the concavity of the glenoid fossa. In any anatomical direction, the humeral head is only covered by 25-30% of the glenoid surface. The joint receives support statically, dynamically, and by negative pressure. The soft tissues such as the glenohumeral ligaments, labrum and capsule as well as the articular surface provide static support. Disruption of the static restraints either due to trauma or inherent joint laxity may lead to a reduction of xe2x80x9cload sharing.xe2x80x9d The ligaments are unable to effectively resist joint translation, which increases joint stability. Specifically, the inferior glenohumeral ligament is the most important component of the complex. In a study done by R. E. Schwartz, S. J. O""Brien, P. A. Torzilli and R. F. Warren entitled, xe2x80x9cCapsular restraints to anterier-posterier motion of the shoulder,xe2x80x9d Trans Orthop Res Soc 12:78, 1987., the inferior glenohumeral ligament was found to be the primary check against both anterior and posterior translation with the shoulder abducted. S. J. O""brien, M. C. Neves and S. P. Anroczky, xe2x80x9cThe anatomy and histology of the inferior glenohumeral ligament complex of the shoulder,xe2x80x9d Am J Sports Med 18(5) 449-456, 1990., concludes from their study that the inferior glenohumeral ligament not only provides support in abduction but also with combined motions of internal and external rotation. The authors suggest that reestablishing the integrity of the inferior glenohumeral ligament may be an important consideration when treating anterior and posterior instabilities.
Dynamic support is provided by the rotator cuff (subscapularis, supraspinatus, infraspinatus, teres minor) and deltoid musculature. The dynamic stabilizers act as barriers to help resist translation and indirectly by moving the joint into a position that tightens the capsuloligamentous structures. Force couples are produced by the subscapularis with counterbalance from the infraspinatus/teres minor muscles in the transverse plane and in the coronal plane by the deltoid counterbalanced by the infraspinatus and teres/minor.
Bracing may become necessary to those who have shoulder instability due to trauma, failed surgical intervention or inherent joint laxity. Providing external dynamic support may allow the individual to return to their previous level of function while possibly reducing the risk of further injury. Previously devised shoulder braces have addressed instability in the anterior and posterior directions but have not addressed the importance of inferior capsular reinforcement or glenohumeral joint compression.
The present invention comprises a brace for supporting a wearer""s shoulder joint during movement. The brace is of one-piece construction and preferably from a stretchable neoprene, loop type material. It provides support to the glenohumeral joint inferiorly as well as joint compression following compromise of the static restraining structures. The present invention can functionally stabilize and assist the individual according to their specific needs during rehabilitation, activities of daily living or sport participation.
The present stabilizing system grips the wearer""s skin so that it can provide support and compression to the shoulder joint. The shoulder-stabilizing device comprises a garment that includes a chest component, shoulder component, axillary component and upper arm (sleeve) component. The strapping mechanism of the device comprises an inferior strap (axillary strap), the axillary pouch, and the compression strap (deltoid strap).
The garment components of the brace are designed such that they cover the wearer""s chest, shoulder, arm and axillary areas. The brace is donned by placing the arm of the injured shoulder through the sleeve component of the garment and pulled superiorly so that the shoulder and axillary components of the brace are securely in place. The chest component is then secured by hook type material to the opposite side of the wearer""s torso and securely fastened. The inner portion of the garment is a rubberized material to assist in providing control and stability. The outer portion is made of a loop type material so that the strapping mechanism may hook to the garment component.
The strapping mechanism is fixated to the garment component. The axillary pouch and the inferior strapping mechanism are continuous. The axillary pouch is a diamond type shape, which is made of a different stretchable material similar to Lycra for comfort and support of the inferior capsule in the axillary area. The inferior strapping mechanism is comprised of two separate straps, one anterior one posterior, are fixated to either side of the axillary pouch. The axillary pouch is in turn fixated to the axillary portion of the garment component. Each strap (one anterior and one posterior to the shoulder joint) of the inferior strapping mechanism is pulled superiorly which in turn causes the axillary pouch to become taught in the axillary area. The amount of tension can be controlled according to comfort. The anterior and posterior portion of the straps are then criss-crossed in the area of the acromioclavicular joint of the shoulder and pulled in an inferior direction. The anterior portion of the inferior strapping mechanism is then fastened by hook type material to the posterior portion of the garment component crossing the mid-thoracic spine. The posterior portion of the inferior strapping mechanism is then fastened by hook type material to the anterior portion of the garment component crossing the mid-sternal region.
The deltoid strap is fixated firmly to the sleeve portion of the garment component in the area of the deltoid tubercle. With equal tension directed at both ends of the strap in a horizontal direction, each end of the strap is fastened with a hook-typed material to the garment component of the shoulder stabilizer. One portion of the strap positioned anteriorly and one posteriorly on the garment component. Compression is then provided to the shoulder joint.
Therefore the objects of the present invention include to provide a shoulder brace which restrains the humeral head from anterior, posterior and inferior translation; to provide such a brace which applies compression to the glenohumeral joint; to provide such a brace which stimulates proprioceptive awareness of the glenohumeral joint; to provide such a brace whereas the criss-cross fashion of the strapping mechanism provides compression to the acromioclavicular joint; to provide such a brace which is comprised of one piece construction; to provide such a brace which is lightweight; to provide such a brace which has an axillary pouch for inferior support of the glenohumeral joint; to provide such a brace in which the tension of the inferior strapping mechanism is adjustable; to provide such a brace in which the tension of the compression strap is adjustable; to provide such a brace which provides support and compression of the glenohumeral joint; to provide such a brace which allows freedom of movement to the individual; to provide such a brace which applicable to multiple glenohumeral instabilities; to provide such a brace which has ease of application; and to provide such a brace which provides comfort to the individual when applied.
Other objects and advantages will become apparent from the following description of the brace and the accompanying drawings.